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Permit CITY OF TIGARD �a,,,,,,., ,,,,,- DEVELOPMENT SERVICES PLUMBING PERMIT ''� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PERMIT # • PLM97 -0337 DATE ISSUED: 08/18/97 PARCEL: 25104BD -03400 SITE ADDRESS...: 12700 SW 135TH AVE SUBDIVISION • HANDY ACRES ZONING: R -6 BLOCK..........: LOT •32 JURISDICTION: TIG CLASS OF WORK..:ADD GARBAGE DISPOSALS.: 0 MOBILE HOME SPACES.: 0 TYPE OF USE -SF WASHING MACH : • 0 BACKFLOW PREVNTRS..: 1 OCCUPANCY GRP..:R3 FLOOR DRAINS • 0 TRAPS : 0 STORIES • 0 WATER HEATERS . 0 CATCH BASINS • 0 FIXTURES LAUNDRY TRAYS • 0 SF RAIN DRAINS • 0 SINKS • 0 URINALS • 0 GREASE TRAPS • 0 LAVATORIES • 0 OTHER FIXTURES • 0 TUB /SHOWERS...: 0 SEWER LINE (ft)...: 0 WATER CLOSETS.: 0 WATER LINE (ft)...: 0 DISHWASHERS • 0 RAIN DRAIN (ft)...: 0 Remarks: Add residential backflow prevention device. Owner: FEES JACK BATALIA type amount by date recpt 5626 SW TARA CT PRMT $ 15.00 GEO 08/18/97 97- 298363 PORTLAND OR 97221 SPCT $ 0.75 GEO 08/18/97 97- 298363 Phone #: Contractor CEDAR LANDSCAPE 14375 SW PATRICIA AVE HILLSBORO OR 97123 Phone #: 503- 628 -3411 $ 15.75 TOTAL Reg #..: 000058 REQUIRED INSPECTIONS This permit is issued subject to the regulations contained in the Rough —in Insp Tigard Municipal Code, State of Ore. Specialty Codes and all other Misc. Inspection applicable laws. All work will be done in accordance with RP /Backf low Prey approved plans. This permit will expire if work is not started Final Inspection within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 0001-0010 through OAR 952 w -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. Issued By: ,./ Permittee Signature: ,-- +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ • CITY OF TIGARD Plumbing Application Recd By 3125 SW HALL BLVD. Commercial and Residential Date Recd 'IGARD OR `'97223 Date to P E, 503} 63 -1171 Date to DST G � Permit se/1 l'-7 -(5,3-7 Print or Type Related SWR a Incomplete or illegible applications will not be accepted called I Name of Development/Project FIXTURES (individual) 1 QTY PRICE f AMT Job Sink 9.00 • ( Street Address Lavatory I 9 00 Address I Butt `,2 PO SW /-3 ruo or Tub /Shower Como. Bi.tg a '. ;t .y/State 9.00 Zip Shower Only 9.00 7/ g'4' 04 Water Closet 1 Name 9.00 4411 -s/4/ Dishwasher I 9.00 Owner Mailing Address 7X Suite Garbage Disposal 9.00 Ia'00 sco j 33 Washing Macnine 9.00 City/State Zip Phone Floor Drain 7? �i1iE ©/Q 2" 9.00 • Name 3' 9.00 4 1 9.00 Occupant Mailing Address Suite Water Heater i 9.00 Laundry Room Tray 9.00 City/State Zip Phone Unnal I 9.00 ' Name Other Fixtures (Soecify) r 9.00 C - 0,4' .4f1irJD5Cs¢aE 9.00 i Contractor Mailing Address Suite I 9.00 • lit?7jis i /9-r.�fC M ,4 r 9.00 (Pnor to issuance City /State �� / Zip Phone applicant must I % /lSF�l1D a", 97f (0�8_.3f// I 9.00 provide all ..,_r-, t. Cont. Board Lic.4 Exp. Date I 9.00 contractors hea 3-gy 3 (o _ 1d 9.00 license Plumbing Lic. rt Exp. Date Sewer- 1st 100' 30.00 information j��,25 6 „ 9? for COT COT Business Tax or Metro 4 Exp. Date Sewer - each additional 100' 25.00 database). Water Service - 1st 100' 30.00 Name '.'rater Service - each additional 200' 25.00 Architect Storm & Rain Crain - 1st 100' 30.00 0 Mailing Address i Suite Storm & Rain Drain -each additional 100' 25.00 Mobile Home Space 25.00 I Engineer City/State Zip 1 Phone Commeraal Back Flow Prevention Cevice or Anti- I I 25.00 I Pollution Device 0escr be .vorx New 3 Addition 3 Alteration C Repair C Residential Backftow arevention Device' / I 15.00 Iii 'o ce cone: Residential O Non - residential C I Any Trap or Waste Nct Connected to a Fixture I 9.00 .Aceit:onal description of work I Catch Basin 1 I 9.00 insp. of Existing F.umoing 40.00 penhr Existing use of Soedaity Requested Inspections 40.00 I `wilding or property I per. hr Rain Drain. single family dwelling 30.00 ' Proposed use of Grease Traps I I 9.00 Puking or property . QUANTITY TOTAL I I I I Are you caooing . moving or replacing any fixtures? Yes - No 71 Isometric x nser ciasrarn •s recuired ,1 Cuanrry Tctat is > . I (If yes see back of form) 'SUBTOTAL I 45 : acknowledge that t nave reac this aopiication. that the information .even is correct. that I am he owner cr authorized agent of the owner. and 5% SURCHARGE ` 1 #,1 - • :hat Mans suomitted are in comcliance with Oregon State Laws. Sign re of OOw'ner /Agent Date PLAN REVIEW 25% OF SUBTOTAL owe/ �v KK // /J ?ecureo only f 5�ru a crr. at s > 9 -XY -77 7 TOTAL 7S' 0ontact Person Name Phone I�t7 D/ / /6s7 'Minimum permit fee is 325 - 5% surcharge. except Residential Backflow D 7e 3 - 1503 Prevention Device. which is S15 - 5% surcharge i :ldstslpimapp.doc 3196 1 'LEASE COMPLETE AS APPROPRIATE TO PROJECT: Fixtures to be capped, moved or replaced j Qty 1 I Sink 1 Lavatory j Tub or Tub /Shower Combination Shower Only Water Closet Dishwasher Garbage Disposal I Washing Machine Floor Drain 2" 3'r i 4" I Water Heater Laundry Room Tray Urinal Other Fixtures (Specify) 1 i COMMENTS REGARDING ABOVE: CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: .639 -4171 BUP Date Requested _ AM PM BLD Location 1,1C I3 Suite MEC Contact Person Ph PLM 45d 33 7 Contractor Ce oIein. tA s!'.ea.x Ph CO71 1 ( SWR BUILDING Tenant/Owner • ELC Retaining Wall ELR Footing Access: Foundation F-11 FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear • Int Sheath /Shear Framing Or/ Insulation Drywall Nailing . 41 1 Firewall 7 'I 4/1/s Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL UMBI Post & Beam Under Slab Top Out Water Service tn Sanitary Sewer Ra' I Drains • i PART FAIL ` HANICAL Post & Beam Rough In rc..„) Gas Line Smoke Dampers Final PASS PART FAIL ELECTRICAL • Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access � / Approach /Sidewalk Other Date ' Inspector C Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. 05/30/2000 Activities for Case #: PLM97 -00337 10:53:20 AM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By. Updated Notes PLMA003 Application received 08/18/1997 08/18/1997 GEO 08/18/1997 PLMA005 Create Permit 08/18/1997 08/18/1997 GEO 08/18/1997 PLMA715 Rough -in Insp 08/18/1997 GEO 08/18/1997 PLMA740 Misc. Inspection 08/18/1997 GEO 08/18/1997 PLMA750 RP /Backflow Preventer 08/18/1997 GEO 08/18/1997 PLMA799 Final Inspection 08/18/1997 05/22/2000 MRS PASS AKJ 05/22/2000 PLMA050 (F) Issue permit 08/18/1997 GEO PASS GEO 08/18/1997 PLMA800 Case Finaled 05/22/2000 AKJ DONE No Hold AKJ 05/22/2000 • Page 1 of 1